C.".. I <br />NOTICE OF RESTRICTION OF USE <br />and Notice of Right to Appeal <br />9 ........ .... !V ------------------------------ <br />DATE <br />fit)( ATION (PARKJOPEN SRA,(�,"E)� <br />. . . ..... . ................. <br />NlNaltric: Last First Middle [)0B, Racill <br />CDs I ° -1 <br />s, plloneork Phone: <br />. ................ . ..... ......... . ............ <br />Under the authority of Administrative Order No. 58-03-24-F and Park and Open Space Rule R-1.005(3), you are hereby <br />notified that you are prohibited from (check box): <br />Entering in or using all City of Eugene parks, opens aces or facilities. <br />The basis for this Notice eafRestriction of I. -Ise is that on 'D you violated Section ...... . . .. . ....................... . . . . . .......... of'the Pafl� <br />and Open Space Rules, and/or, S'cc,6on 3LA-1-a ofthe Eugene Code, 197 1, and/or ORS --- <br />I AZ <br />(Description of the violation.) <br />This restriction of ruse is effective beginning onDn�N�.i and shall remain in effect u. -H. <br />If you. enter in or use any City of Eugene park, open space or facility during the effective period of this lNotice, you may bt.� <br />arrested sand. charged with criminal trespass in the second degree. <br />Pursuant to Park and Open Space Fume R- 1.0174 y oru are en ti fled to an in forinal haming to contest this Not ice. A.rc(juerr,.,,tfbira!n, <br />informal hearing must be made in writing and filed withi the Parks & (Ven Space Division Director (,"-the Dvipion Directiot") <br />wYiffiin 48 hours (exclusive of vieckends) (if receipt of this Notice atthe following address:: 1820 Il oosevelt, Blvd., Eugene., OR <br />97402. <br />The Division Director shall schedule a titne and place for the info al hearing to be conducted, which shall lie not rnoru thzua <br />72 hours (exc1usive of weekends) of receipt of the recluest for hearin. At the informal hearing the Division Director �611 only <br />9 1 <br />consider testimony from yoti., Cilia personnel involved in the incident that resulted in this Notice-, and other, %vitnesses 1�o t1u.,, <br />incident. The Division Director may exclude anyone, other than you and those presenting testimony, from the informal hican-jig, <br />This Notice shall reinain in effect pending, any requested hearing. <br />chis Notice of Exclusion wa% delivered to the person named at the top of this N' ct the date and time shown abovir l.:)y: <br />---------- - - --------- ------------------ - ---------------------------- <br />............ ..... . . <br />(Signature ofperson i%suing/defivering notu.:cl <br />I hereby acknowledge receipt of the above Notice on the date and time indicated above, <br />(Sig,naturc of person benng ir�Rled thio noticle!) <br />Nvtwl� Cop"r pkkhllu Works Grkxm tpy:' FOv.,. V .990.k v Copy: R r�� Poo C' upy Pink Copy: Rrxpkn� Go (:'cpy: iC.kC h.'er Appf.a I nouce Rvv- R-4/011 <br />